Edward W. Kelly, MD, MBA

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Before your Appointment

Bring in any x-rays, bone scans, CT scans, MRI films, laboratory blood work, operative reports, your insurance card and identification to your appointment. This may mean contacting the office where you had images or tests performed and having the results faxed to Dr. Kelly’s team at 952-456-7802. Otherwise, you may bring a disc or paper copies of those results to your appointment.

At your initial appointment, you will check in at the front desk and complete some paperwork, including demographic information and medical history. You will be called back by a clinic assistant and will be asked various questions regarding your orthopedic complaint. Most often, x-rays will be ordered and obtained before being seen. You will then be seen by the provider and a plan will be discussed with you. Most often, this includes a possible cortisone injection, physical therapy, or an MRI scan, if necessary. You will discuss with the provider when you should return for a visit and what you should be doing in the meantime. Any final questions you may have for the provider should be asked at this time.

If your injury is going to be claimed under work comp, make sure you report your injury to the HR department at your work so that a file is created for your injury. Most advanced imaging or procedures that may be recommended will require work comp approval before they are done, and if the injury is already filed appropriately with your employer, this will speed the approval process along. You will be asked to provide your Work Comp claim information at the time you make your appointment as well. It will be helpful to us to have your claim adjustor name, phone number and fax number.

After your Appointment

It is very normal after receiving an injection to have pain relief at first but then to have the pain return. Your initial pain relief is caused by the numbing medicine in the injection. It is similar to the Novocain used at the dentist office. Cortisone is a very strong anti-inflammatory and was placed into the area by the injection. It can take a few days to notice the effects, or possibly even several weeks. You may not have a sudden change in your symptoms as your pain will gradually improve. Often, an injection is given along with a prescription for physical therapy. The combination of the two, over time, will improve your pain and function.

You will be in the sling for 4-6 weeks. You can remove the sling for hygiene and for gentle range of motion exercises. We want you to stay in the sling to avoid re-injury to your repair. We don’t want you falling, reaching away from your body or using the arm to lift anything heavier than a glass of water or telephone during those first 4-6 weeks after your surgery to protect the repair.

Generally speaking, your pain will improve within a few weeks from surgery. You will start therapy to increase your shoulder motion around 6 weeks and will start strengthening at 3 months. You are usually 70-80% improved at 6 months but it can take up to one year to notice complete improvement.

Following a knee replacement, you will spend about 3 days in the hospital. After being discharged from the hospital, you will either return home or go to a rehab facility, depending on your home situation. If you do go to rehab, this will be arranged while you are in the hospital and cannot be arranged before surgery. You will start physical therapy and walking shortly after surgery. A physical therapist will either come to your house or you will go to outpatient therapy. If you know you will be going to outpatient therapy, you can schedule that appointment as soon as you have your surgery date set. You will return to the office around 2 weeks post-op for x-rays and wound care. We would like you to be able to bend your knee to about 90 degrees at your first post-op visit. You will then receive another prescription for physical therapy. You will return to the office in 4-6 more weeks to check your motion. Depending on your progress, more therapy will be prescribed and you may possibly start pool therapy. You will be reminded throughout the process for the need to take antibiotics before any dental or other invasive procedures. You will take those antibiotics for the rest of your life to prevent infection.

Dr. Kelly and his team are pleased to provide most intra-articular injections in the office under ultrasound guidance. The ultrasound machine is used to guide the needle into the joint and make sure the medicine gets injected in the right spot. For this procedure, you will lie down on the exam table and the injection site will be cleaned. Your skin will then be numbed with an injection of lidocaine (an anesthetic). After about 10-15 minutes, once the area is numb, the cortisone will be injected using a sterile ultrasound transducer cover, sterile ultrasound gel and sterile gloves. Patients will typically notice early relief that same day or shortly after from the anesthetic, which may taper off. It may take a few days to weeks to notice the full effects of the cortisone. In some special cases, we may order a fluoroscopic-guided intra-articular injection, which can be performed at the hospital or other special diagnostic centers. This type of procedure uses x-ray guidance to ensure proper placement of the injection into the joint.

If Dr. Kelly or his PA Lindsey order an MRI scan to further evaluate you, they would like to see you back in the office to review those results. By reviewing the MRI scan together in the office, versus hearing the results over the phone, you can actually see the scan and gain a better understanding of your injury and the appropriate treatment options. This helps Dr. Kelly personalize the best treatment for you at that time and treatment can be initiated at that visit, whether it be scheduling surgery, starting physical therapy or providing an injection.